Long Term Care Laws and Regulations

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 What Is Long Term Care?

In short, long term care occurs when an elderly or special needs person can no longer take care of themselves due to medical reasons and they require medical supervision and nursing assistance on a daily basis. As such a long term care facility is a facility that houses elderly or special needs individuals and employs medical professionals that specialize in providing care for the individuals that are housed in the facility.

Long term care facilities are focused on providing coordinated, and often direct one-on-one care services, in order to meet the needs of the patients present at their facility. However, if the facility falls below a reasonable standard of care in providing patient services, and a patient gets injured at the facility, then the long term care facility or medical professional responsible for the injury may be subject to liability under long term care laws.

It is important to note that long term care laws will vary by state, but they will generally be located in the state’s elder laws and medical malpractice laws. An experienced long term care attorney will be most familiar with the exact long term care laws that apply in your local jurisdiction, and will be able to assist anyone seeking to understand whether or not they can hold a medical professional or long term care facility responsible for their or their loved one’s injuries.

Types of Long Term Care Facilities

There are numerous different types of long term care facilities that are available to the elderly or individuals with special needs. As far as selecting the right facility for you or your loved one, that will depend on the level of care necessary, such as if the facility will need to provide skilled nursing tasks, as well as the financial means of the person seeking care in the long term facility.

Examples of common types of long term care facilities include:

  • Hospital-based skilled nursing facilities;
  • Skilled nursing facilities (“SNF”);
  • Intermediate care facilities (“ICF”); and
  • Custodial care facilities.

Nursing home care lawyers are lawyers that specialize in both assisting individuals in finding nursing homes appropriate for their care and needs, as well as representing clients that may have been abused, neglected, or otherwise harmed while at a long term care facility.

Hospital-Based Skilled Nursing Facilities

A hospital-based skilled nursing facility is a type of long term care facility that is able to provide skilled nursing tasks. Skilled nurses are highly trained medical professionals that are able to provide direct care to a patient, and perform certain procedures necessary for a patient on a daily basis. These facilities are also commonly referred to as extended care facilities.

Hospital-based skilled nursing facilities are typically the appropriate long term care facility for individuals with serious medical needs, or individuals that are recovering from serious illnesses or injuries. These facilities also typically offer the highest level of medical care, which results in the facility being one of the most expensive facilities. Hospital-based skilled nursing facilities are often only intended as a temporary care facility.

Skilled Nursing Facilities (“SNF”)

Skilled nursing facilities are long term care facilities that provide a very high level of medical care, similar to that of hospital-based skilled nursing facilities. SNFs are usually best for individuals who have illnesses or impairments that require close monitoring on a daily basis.

Skilled nursing facilities typically offer all of the following:

  • 24-hour supervision by vocational and registered skilled nurses; and
  • Rehabilitative therapy services.

Intermediate Care Facilities (“ICF”)

Intermediate Care Facilities are long term care facilities that offer a level of medical care that is just below that of SNFs. ICFs are best for individuals that have chronic ailments, but who do not require close monitoring and skilled based nursing on a daily or constant basis. However, ICFs still cater to both medical needs as well as personal assistance for the elderly and individuals with specific needs. ICFs also offer 24 hour supervision by licensed nurses and are intended for long stays.

Custodial Care Facilities (Nursing Homes)

Custodial care facilities are long term care facilities that provide personal assistance to the elderly or individuals with special needs that involve non skilled nursing tasks. Nursing homes typically provide recreational and social activities for all of the residents at the facility.

However, nursing homes do not typically offer skilled nursing tasks or rehabilitative therapy services. An individual could have a skilled nurse come into their nursing home and provide those services. Nursing homes are often the least expensive of all long term care facilities.

Long Term Care Insurance

Long term care insurance is an insurance plan that is not generally not provided in most health insurance plans. Long term care insurance policies cover a wide range of long term care options, including providing for payments to long term care facilities. Individuals are able to purchase long term care insurance policies for a set number of years of care or for indefinite coverage.

Insurance policies can vary significantly in terms of payment terms, as well as the level of care that is included under the plan. In many cases Medicare or Medicaid may also be available to support an individual’s need for long term care. Obtaining long term care insurance is a good way to ensure that you or your loved one’s receive the care needed.

Elder Abuse and Neglect

The two most common lawsuits brought against long term care facilities are instances of elder abuse and elder neglect. Elder neglect occurs when the person responsible for providing care to an elder fails to provide that person the proper care. Victims of elder neglect are most often senior citizens who live in long term care facilities, and are unable to care for themselves on a daily basis. In most states, an elder is defined as any individual over sixty years old. However, some states define an elder as any person that is over the age of sixty five.

Neglect is often mentioned alongside elder abuse, but most jurisdictions distinguish between the two terms. Neglect generally implies that the victim was neglected, and didn’t receive the proper care and attention due to the caretaker falling below a reasonable standard of care. Common examples of elder neglect include:

  • Failing to provide the basic necessities for the elderly person, such as food, water, clothing, and shelter;
  • Failing to administer medicines or treatments to the elder according to their physician’s instructions;
  • Allowing the elder to live in unreasonable poor, uninhabitable, or unsuitable living conditions; and
  • Failing to communicate important information to another person as requested by the elder, especially when such failure results in the physical harm of the elder.

In contrast to neglect, most state laws define elder abuse as any act that results in direct physical harm to the elder, such as striking them.

Types of Elder Abuse

As mentioned above, elder abuse is different from elder neglect cases. Elder abuse can also include direct emotional and mental harm to an elderly person. In fact, in many states elder abuse is further classified as either passive or active abuse.

Passive elder abuse occurs when the long term care facility’s accidental negligence results in the elder’s abuse. Active abuse occurs when the long term care facility intentionally fails to meet the elder’s needs. Active abuse most often occurs as a result of hostile tension between the elder and a caregiver at the facility. Active abuse is also often accompanied by criminal charges being filed.

Additional types of elder abuse may include financially taking advantage of an elderly person, such as using their financial resources without their consent or defrauding the elder person or individual with special needs. All of the above would be considered to be long term care abuse, and anyone that harmed the elderly person would be subject to civil and criminal liability.

Do I Need an Attorney for My Long Term Care Facility Matter?

If you know someone you know has suffered harm as a result of a long term care facility, it is in your best interests to immediately consult with an experienced insurance lawyer.

An experienced insurance lawyer will be knowledgeable of all laws regarding long term care, and will be able to assist you or your loved one in finding more appropriate care, or assisting you in holding the person that harmed you or your loved one liable. Finally, an experienced attorney will also be able to represent you in court, as necessary.

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